Abstract: :
Purpose: Many factors are known to contribute to dry eye syndromebut therapy generally consists of artificial tears. This treatmentcan provide short-term symptomatic relief but it does not treatthe underlying problem. Sullivan has shown a pivotal role forandrogens in the treatment of dry eye.Androgens play a key rolein regulating the function of both the lacrimal and meibomianglands. DHEA is a steroid hormone produced naturally by theadrenal glands that has 5% of the androgenic activity of testosterone.The present study compares artificial tears supplemented withDHEA or testosterone for its effect on TBUT and Schirmer test.Methods: Twenty subjects age range 24 to 65, mean age 40.2 yrs11 males and 9 females who had a subjective complaint of dryeye were enrolled in this double masked study. The subjectswere divided into three groups: one group received artificialtears supplemented with 1% testosterone, the second group usedartificial tears supplemented with 1% DHEA, a third used artificialtears alone. Subjects used each of the drops 4 times daily fortwo weeks. The groups were changed after two weeks of drop useuntil each subject used all three drops. Baseline TBUT(tearbreakup time) and Schirmer test were done prior to the studyand after the use of each the three artificial tears preparations.Results: Baseline TBUT 5.3 +/- 2.25, Artificial Tears 5.4 +/-2.37,Testosterone 5.1 +/- 2, DHEA 7.6 +/- 1.8. Schirmer baseline14.95 +/- 6.7, Artificial Tears 14.8 +/- 8.5, Testosterone 11.85+/- 4.9, DHEA 21 +/- 6.2. ANOVA with post hoc student Newman-Keulsreveals that the TBUT and Schirmer test results with 1% DHEAare different from baseline, artificial tears and testosteroneat p=.05 level. Patient questionnaire indicates all subjectsfelt the drops with DHEA or testosterone were irritating, but60% felt the DHEA reduced their symptoms better than the artificialtears and 50% said the product also provided longer relief thanartificial tears.Conclusion: DHEA supplementation of artificialtears improves TBUT and Schirmer test results. Subjectivelythe patients felt the DHEA drop worked better than artificialtears or teststerone. This study supports the notion that additionof androgenic hormones to artificial tears may benefit dry eyepatients.